Educated Patients Decrease Fraud and Increase Quality of Care

Mission offers tools for patients to learn and empower themselves to know their options and rights during National Healthcare Quality Week, October 20-26

SAN DIEGO (May 24, 2013)—Mission Healthcare, which offers medical and non-medical services in the home, educates patients and consumers on their rights and choices in healthcare services.

“Many individuals think whatever their doctor prescribes is their only choice—that is incorrect,” said Amy Nelson, Director and Co-Founder of Mission Healthcare. “Patients and families need to be their own best advocates and we need to educate them on how to make the best choices.”

Many people do not realize that care in the home is an affordable option. Numerous studies show that it is both financially and psychologically important it is to keep elderly and ill family members in the familiarity of their homes for as long as possible.   It is the ideal healing environment, where access to loved ones and familiar surroundings shortens recovery time. The technology that is now available allows care previously only available in a hospital setting to take place in the home.  With consistent home care, lengthy hospital stays are prevented. Elderly patients are more susceptible to infection in the hospital. At home, they are more inclined to stay active when they are able to maintain normal routines.

“We need to educate consumers on how to pick agencies that are reputable and let them know they have the final decision in who provides them service,” said Nelson.

Educating yourself about an agency is the best way to determine the right fit for you or a loved one. It also helps keep fraud in the home health industry down, which costs consumers and providers alike.  Legitimate providers are bearing the weight of fraudulent ones because the federal government has reduced payments due to an increase in Medicare spending.  Much of the increase is from fraudulent providers who in many cases are billing for services they never provided.

“If we can educate consumers and providers, we should be able to speed up the needed cleansing process,” said Nelson.

Below are questions consumers should be asking about Home Health, Home Care and Hospice agencies so they can be empowered to select the right agency and hold them to better quality of care:

Home Health—Medical care provided in the home usually following surgery, injury, or diagnoses of an ailment.

• Does the agency guarantee a visit by a licensed healthcare professional within 24 hours of receiving a referral?
• Does the agency care for patients that require complicated and complex treatment protocols?
• Do they offer specialized behavioral health services?
• Is the agency Medicare certified?
• Do they have a healthcare professional on-duty 24 hours a day, seven days a week (not an answering service) to answer all questions?
• Does the agency have procedures in place in case of emergencies?
• Do they offer all disciplines included in home health benefits?

Home Care—Non-medical care in the home such as grooming, bathing, meal preparation, and surgical aftercare.

• Does the agency you are considering require you to purchase a minimum number of hours per day?
• Will the agency agree that you and/or your loved one can interview caregivers until you find the one that is right for you?
• Do they provide transportation for errands, appointments and shopping?
• Does the agency perform detailed background checks and drug tests on all employees?
• Do all caregivers receive at least 16 hours of Orientation and Training by qualified individuals?
• Does the agency guarantee a visit by a skilled home care professional within 24 hours of receiving a referral?
• Does the agency perform on-site visits to introduce the caregiver at the beginning of care and periodic onsite visits to ensure that the quality of care is maintained?
• Do they have a skilled home care professional on-call 24 hours a day, 7 days a week to answer questions?

Hospice

• Does the hospice agency offer alternative treatment approaches to managing pain?
• Does the agency guarantee a visit by a licensed healthcare professional within 24 hours of receiving a referral?
• Does the hospice provide 100 % attention during the first 48 hours of admission?
• Does the hospice agency help to reduce the family’s fear of loss?
• Is the agency Medicare-Certified?
• Does the agency have any nationally recognized accreditations?  
• Do they have a healthcare professional available 24 hours a day, seven days a week?
• Does the agency have procedures in place in case of emergencies?
• Do they offer a variety of treatment approaches to accommodate the needs of a variety of patients?

Differentiators that Mission has enacted to hold the industry to higher standards:

• The bylaws are written so that Mission can never be sold to a larger corporation, preventing reporting to shareholders who would only be concerned with the bottom line.
• No owner is found among the top 25 of the highest paid employees, and in fact did not take salaries for the first year while getting the company established.
• Mission offers unique services with no minimums. If you need a home care provider for 30 minutes or an hour, Mission will send someone when other agencies require a minimum of four hours, which makes it very expensive for people in need.
• They have an unheard of policy where there is a live person available 24 hours a day to speak with anyone in need.
• They also have an unheard of policy that when someone is in need they will have someone in the home within two hours!
• For some services, many individuals have difficulty getting their insurance provider to pay. It can be very daunting for a consumer to try and figure out the logistics. Mission’s team navigates the insurance world for the patients so they do not have to worry and lessens their out of pocket costs.
• Mission does some of the most extensive background checks in the industry. They do multi-state background checks making sure that the providers they send into the home are of the highest quality. They also offer a guaranteed placement where at no additional cost you can request new caregivers until you are 100% satisfied.
• Make their employees top priority. They know that happy employees mean better quality of care for the elderly and the ill. For example, they added “Cadillac” health benefit programs and removed mandatory waiting periods for new hires so that all employees were eligible immediately.

About Mission:

Mission is a clinically owned and operated organization whose services include Mission Home Health, Mission Hospice, and Mission Home Care.  By providing a these three business lines, Mission Healthcare strives to have a positive impact on the lives of patients, their families, and their healthcare partners no matter what their needs may be. Mission utilizes all available resources to provide the highest level of care possible to their patients, all while in the optimal healing environment, the home.